Wednesday, January 18, 2017

A Man of Science

"The Doctor" (detail), Sir Luke Fildes (1890)

Dr. Tinker’s next patient was Willioughby Cranston. It was the kind of situation he dreaded, that he had never gotten used to. As a doctor he was a man of science, but he was deeply empathetic. As a boy it used to pain him so much that he winced and looked away when he saw a seriously disabled or scarred person, particularly if they were young.

“Doctor, is there any hope?” Cranston asked after sitting down in the wooden chair next to the doctor’s desk. Cranston looked like he had spent an agonizing week since Dr. Tinker had last seen him. He looked grim, like he hadn’t shaved or slept much in the last week. The meticulous Certified Public Accountant had been a patient of the doctor for nine years. He had always been upbeat, trim and carefully groomed. Now, almost overnight, he looked like a haggard prisoner on death row. His rumpled suit looked like he had been sleeping in it all week. The white collar professional looked like a depressed, sallow, blue collar insomniac.

“We should never give up all hope, Mr. Cranston,” the doctor said. “But the test results from the specialist only confirm what I said was a probability last week.”

“And time, doctor?” Cranston asked. “How much have I got?”

Dr. Tinker paused a few seconds before answering, but he knew for a patient in Cranston’s situation those few seconds could seem to drag on forever. Being the bearer of bad news, the doctor couldn’t help hesitating, but he did not believe in either miracles or God. He knew that most people did, but most people were not men of science. The doctor could even have told Cranston that he might live longer than the doctor himself, who was under treatment by a heart specialist and was retiring in six months, five years earlier than he would have if he hadn’t developed serious heart problems. He could have told Cranston that he might live longer than he himself would, but of course he didn’t because that would have been unprofessional. His aim was to help patients, not to enable them to deny the truth.

The few seconds the doctor paused might have seemed to Cranston to take forever because he had had more than one tragedy to deal with in the last couple of years. His youngest son, who had been a star athlete in high school, had gotten involved with drugs and had died of an overdose two years ago, as Dr. Tinker's only child, a quiet studious boy, had eight years earlier. And Cranston’s wife had died of breast cancer only months ago. The doctor felt his retirement in six months could not come soon enough. He felt he had aged ten years in the last five. He had been a conscientious, dedicated doctor his whole career, but now he longed to hang up his stethoscope.

When Dr. Tinker reported the bad news to Cranston, the CPA’s shoulders slumped and his fists clenched as he leaned forward in the wooden chair and stared down between his legs at the floor. The doctor made an attempt to get Cranston to accept his fate philosophically, but that had little effect. After the forlorn Cranston had shuffled out of the office, Dr. Tinker’s nurse, Miss Truitt, stepped into it.

“Who’s next, Miss Truitt?” he asked. He was still distracted by the despondent Cranston’s departure. He could not help being identified with patients, or at least the terminal ones. But under the circumstances, there was only so much a man of science could do.

“Mr. Jones is next,” she said. “His file’s on the top of that pile on your desk.” She stepped over and found the file for him.

When he had recovered from his wife’s death, Dr. Tinker had sometimes daydreamed about marrying Miss Truitt. His daydream of fathering a child with her, hopefully another son, was probably only a fantasy. By the time Miss Truitt first came to work for him some years ago, she possibly even then had passed the child-bearing age. And besides the way things were going from bad to worse in the world, bringing children into it, knowing what he did, would have been selfish, perhaps unconscionable. As a man of science he wasn’t like most people. He wasn’t in deep denial about the impending climatic holocaust.

“Give me a few minutes before sending him in, please,” he told Miss Truitt

“Yes, doctor,” she said, as she turned around to leave.

In the few minutes he had at his disposal, he went into the bathroom in his office to urinate. The need to frequently urinate was an increasingly bothersome age-related problem for him, just as enuresis, or bedwetting, had been a problem in his childhood. He hurriedly but thoroughly washed his hands after urinating. He never shook hands with others. He had delivered a paper at a medical conference on the health risks of shaking hands. “If Doctors Won’t Stop Shaking Hands, Who Will?” was the title of the paper. Bowing slightly was the customary greeting in Japan, which made so much more sense from a sanitary point of view, than shaking hands. After washing his hands, he stared for a few seconds at his face in the mirror over the basin. He saw himself as gaunt and cadaverous, like a terminal patient.

At the end of the long day, bone weary and with a slight headache, he felt like death warmed over. He was scheduled for three hours duty that evening in the local hospital, but until then he had some free time for relaxation. He turned on the FM radio to listen to classical music. But the music playing did not help him relax. It was Mussorgsky’s ominous Night on Bald Mountain, which was followed by a top-of-hour news report that included an interview with one of the candidates in the presidential election who was quoted as saying climate warming was a hoax being perpetrated by the Russians. Dr. Tinker calculated that it was only a matter of a couple of decades, at the most, that the planet would be “warm” as Hades, “warm” enough to make life extremely uncomfortable for many of the planet’s inhabitants, with the seas rising and shore lines receding. He considered the term “global warming” a linguistic palliative, an ostrich-head-in-the-sand euphemism. Warming indeed! He remembered when he was only a kid how a gasoline shortage had turned the drivers of cars in long gas lines over the edge. Road rage was just one way in which the underlying anger of human beings, particularly Americans, found expression. The thin veneer of civilization covered up the homicidal impulses that men felt in extreme situations. And their impatience would be more pronounced in the most technologically advanced countries where the inhabitants had been spoiled like the children in a rich, self-indulgent family.

Homo sapiens, thinking hominids, as humans flatteringly named themselves, relied on their capacity for denial to deal with the unpleasant facts of life. They would continue to be scientifically illiterate, unable to read, let alone understand, the writing on the wall. With his scientific education and skeptical frame of mind, Dr. Tinker could not help reading and understanding the writing. He believed our days as a self-deluding species was ending. It was not thousands of years in the future that civilization would collapse, according to the vague calculations that prevailed a generation of two back, and not hundreds of years in the future either, but only decades when even the most dim-witted would know that something was going terribly wrong. The chaos was already being foreshadowed in politics where the emotionally and mentally unbalanced were taking over, not through coups but in so-called democratic elections. A serious personality disorder no longer disqualified people for public office. On the contrary, it empowered them. In a world in which the electorate seemed unable to make up their minds, the single-mindedness of a nutty candidate was a valuable political asset.

Given their single-mindedness, because they appear so sure of themselves, the emotionally and mentally disturbed, oblivious to their own nuttiness, would be able to easily mislead the masses who, as Thoreau wrote, “lead lives of quiet desperation.” Facebook and Twitter would facilitate the dissemination of misinformation and lies. Delusions would pass for policy and idiocy for ideology. It had happened in the first half of the twentieth century, in Germany, then considered the most technologically advanced and most scientifically knowledgable nation in the world. Slide rulers rather than computers were rampant back then, when the world was in the analog rather than digital mode. Change now takes place much faster and much more completely.

At his age and with his heart problems, Dr. Tinker would probably not be alive for the worst of it. But the younger a person was, the more nightmarish his or her future would be. There was one blessing to Dr. Tinker’s son having overdosed. He would not experience the holocaust. Dr. Tinker considered the childless fortunate because they did not have to be saddened by the probability that their descendants, particularly their children and grandchildren, would suffer gravely in the relatively near future.

He looked up at the clock on the wall of his office. His free time was almost up. His freedom to philosophize and fulminate was at an end for now. Though utterly exhausted, emotionally and physically, he had to get up out of his desk chair. He clutched the arm rests of the chair tightly to lift himself out of it. But as he began to lift himself up, he felt sharp pains on the left side of his chest. He sank back down into the chair, suddenly realizing he had forgotten to take his heart medication that morning. The vial was in the top right hand drawer of his desk. He tried to reach for the drawer, but the chest pains prevented him. He felt paralyzed. Was it a stroke? After taking several shallow breaths, he succeeded in reaching the drawer. He pulled it open and with a trembling hand took out the vial of pills. Getting the child-proof cap off was a challenge to any senior citizen under the best of circumstances. In his condition it was like cracking a safe. When he at last had it open, he poured several of the pills on his desk. Then he picked one up by using two trembling fingers like tweezers.

He stared at the pill between his fingers, which he now became confoundingly reluctant to take because death now seemed like the most convenient, over-the-counter anodyne for life. Dying would end his misery, would end his obsessive brooding about global warming. He had done his time. He had worn himself to a frazzle doing good by doctoring and worrying about others. But his sense of duty was deeper than his feelings of exhaustion and dejection. He told himself he had to take the pill. But was there still time? Had he waited too long? He had to take it immediately, but his mouth was dry as the Gobi Desert. He might choke to death if he tried to swallow the pill without water. He looked at the water cooler near the door. It was only about ten feet away, but in the condition he was in it looked like ten miles. He thought he might drop dead on the floor if he tried to walk to it.

Then he noticed on his desk the cup half filled with coffee. He usually didn’t drink all of the coffee in a cup. He had given up nicotine, but he hadn’t been able to give up caffeine. He believed coffee was the entry level drug in most of the world, except for Japan, England and Russia, where children as well as adults preferred tea. His favorite author, Chekhov, a doctor, had told an acquaintance that “coffee was wonderful,” and he said if he didn’t drink it “my work suffers.” He put the pill in his mouth and raised the cup with his two trembling hands to his lips and swallowed the coffee and the pill. Having accomplished what had felt like one of the labors of Hercules, he put his arms down on the desk, resting his head on them.

When he next looked up at the clock, he saw some twenty minutes had elapsed. He felt rested, as after an afternoon nap. He flexed his fingers, which were no longer trembling. Then he slowly lifted his arms and flexed them slowly, like a paraplegic in an exercise class. Finally, he raised himself by the arms out of the chair. Standing up, his head was clear and more importantly he was still alive. He slowly circled around the office a few times, trying to reorient himself to reality. He knew he was standing in his office, but he was not sure where he stood in the universe. He knew what he didn't believe, but just what did he believe in? He couldn’t say. As a man of science, he had felt obliged to wrap his mind around the theory of relativity, to the notion that space and time were curved and in some dimension ultimately coalesced. The universe was going in circles, if he understood the theory correctly. It sounded more like science fiction than science.

“Yes,” he said aloud to himself, as if he was talking to a patient. “You can carry on for at least a while longer. You probably don’t have much time left, but you’ll make the most of it. And stop identifying with terminal patients and obsessing about global warming, at least for now.” Then, to keep his spirits up, he recited a poem, “Invictus,” that students of his generation had been required to remember and which he had never forgotten.

Out of the night that covers me,
Black as the pit from pole to pole,
I thank whatever gods may be
For my unconquerable soul.

In the fell clutch of circumstance
I have not winced nor cried aloud.
Under the bludgeoning of chance
My head is bloody, but unbowed.

Beyond this place of wrath and tears
Looms but the Horror of the shade,
And yet the menace of the years
Finds, and shall find me, unafraid.

It matters not how strait the gate,
How charged with punishments the scroll,
I am the master of my fate:
I am the captain of my soul.